Since the past few years, medical practices have seen stagnancy or declining medical reimbursements especially with the continuous rise in practice costs. Most practices are unable to understand the core reasons for dipping revenues and increasing denials.

Expert medical billers and Coders have recently come together to find out the top 10 blunders that physician offices are making which results in denials. The most disappointing problem is that they are unaware of these mistakes and commit them regularly without any amendment.

The most common mistakes that a medical billing office can make are elaborated below :

Piling on Old Coding Books : some of the physician offices still utilize old coding books as reference material but it is not advisable. With each passing year, new CPT, HCPS as well as ICD-9 coding books should replace the older versions; if at all the office is still interested in coding with the help of books.

Most of the practices refer to codes that are available electronically, already built into their software. Codes are easily searchable and more resolutions are available on special coding software like Encoder Pro.

Blaming poor performance of Payers: The relationship between insurance payers and providers is a sensitive process of the reimbursement process. Inability of Medical billers and Coders to do their part of the bargain in time and blaming Payers of stringent regulations, can sometimes make the rate of denial go higher.

At the end of the day, medical billers and coders must recognize that sinking reimbursements as well as increasing write-offs affect their practice. It would be their initiative to improve the quality of claim to get paid better.

Assuming the Patient is still under the same Insurance Plan: Presumption can be a big reason for claim rejection, front office staff cannot be taking it for granted that a patient is still under the same insurance plan. It is the tendency of patients to change their insurance policies. So, the billing office should confirm every single time if the patient has any new information to add to his demographic information thus saving thousands of dollars from refiling and rejection.

More importantly, physicians must ensure that their front office is not overworked to check this crucial information.

Not Measuring Key Performance: Not closely monitoring key performance is a major mistake committed by physician offices. A professional practice flow knows that keeping track of Medical Billing performance is critical Financial Reporting or tracking key performance indicators has always been undermined which also includes days in accounts receivables outstanding, trial balance on accounts that has gone aged and other such important indicators.

Engaging Wrong People: Healthcare jobs seem to be the most stable growth opportunity and thus lots of people hope to get into Medical Billing and Coding jobs, the result medical billing and coding courses are enrolling many students without making any potential. It is important to put stress on finding the right medical billing personnel with appropriate experience and willingness to grow. Even for the experienced Billers checking references for new recruits, verifying credentials and conducting a relevant test before deciding to hire can be a good idea. Physicians must also consider bringing the administration team together and setting good processes right in the beginning.

Not Verifying Patient Benefits: As a patient’s plan changes all the time, their deductibles as well as co-pays also changes. The preauthorization of patient benefits though time consuming should be not be scraped and it is recommended that the physician office should develop a policy as well establish a time frame in order to verify the process of patient benefits.

Never Fully Utilizing a Practice Management System: The way systems are developed these days, most physician offices don’t utilize them even 40% of its capacity, especially if an untrained user is operating it. Exploring the potentials of your system helps you take maximum benefit of your investment in Practice Management Systems.

Besides old, outdated management software can pose a lot of problems and engage a lot of cost in maintenance and up-gradation. So it is the duty of every physician office to have adequate knowledge, develop one’s own skills and at the same time reach out to other users in learning from them.

Missing on Patients Vital Information: Sometimes medical billing offices make the mistake of not taking down patient’s vital information such as his/her telephone number, preferred insurance and other benefits. It is necessary to note down all of these into an encounter form since this information is bound to play a crucial role in the collections process later on.

Missing out getting a sign on some critical forms for information release and Advanced Beneficiary Notice can later impede efforts on denial management or even appeals.

Failure in automating: Automation is necessary for maintaining profitability in this competitive market. With the usage of electronic health records, it has become easy to overlook the applications of various technologies. Medical Billing can be simplified physician offices work more with fewer employees, but for which a strong base in the technology is required.

Keeping up with new demands can happen only with new technology to simply and automate routine tasks. Failure in automating definitely impedes practice growth.

Failure in Prioritizing their Work: With the rate of work increasing all the more, prioritizing work can become quite critical for billing offices. They have to manage a number of responsibilities such as payment posting, appealing denials, A/R receivables and so on but they will have to know how to prioritize their limited time.

Addressing many such issues is the expert billers and coders of medicalbillersandcoders.com - the large consortium of medical billers and coders. These billers have come together to be trained and grow with the healthcare fraternity, they help physicians across 50 states avoid blunders as mentioned above. With hundreds of billers available in the every specialty and having different software experience,Medicalbillersandcoders.com is here to streamline physician offices and improve collection unconditionally. To counter all these common errors, these billers take a number of steps to ensure efficient billing including keeping themselves updated with the latest CPT codes as well as billing software, help in maintaining an amicable relationship with payers, automation and so forth. The biggest positive of these billers is that they are willing to grow and accept change as it comes.

They bring along with themselves the expertise and help your current staff accommodate the best industry practices. This consortium was created by specialists of the healthcare industry for the convenience of the healthcare providers keeping in mind the best criteria to shortlist the best medical biller or coder in your area.

You may think that hiring the services of a medical billing specialist will be like adding extra costs to your practice. But actually, hiring the services of a medical billing specialist can be considered as one of the smartest moves on your part in terms expanding your business. Think about the ways you can be benefitted by them.

Your already overworked staff won't have to spend a large amount of their time at the copy machine because a majority of the records can be handled online, with the use of secure and encrypted technology.Medical billing specialists will ensure that the claims are properly coded and submitted in time.

Your staff doesnt have to face any interruptions with patients queries as those will be handled by these specialists. More over their style of developing Patient Statement barely leaves scope for queries.But one can refer to a few things before hiring medical billing specialists. The top most questions to ask before hiring a medical billing specialist may include:

Qualifications and Certifications: The most important requirement in terms of hiring a medical billing specialist is perhaps his/her qualification. Medical billing certifications are a necessary yardstick to determine whether a medical biller is qualified to take up the job. CPC, CPC-H, CCS-P, CCS, RCC, and OTR are some of the exams which can get a biller approved for Medical billing processes.

Experience:Medical billers nowadays possess experience in a number of specialties. Before hiring a particular biller, ask if he/she has experience in your particular specialty, has understanding of applicable coding subtleties and questioning them about their style of payer follow up can be a good idea, most payers these days are keen on IVR communication, with which Billers must be familiar. Besides, they should also be able to come up with resolutions in case of claim rejection.

Location:Medical billers and coders can be contacted from far and wide, in this day and age of electronic claim submission, physician offices also prefer home-based professionals. But some practices prefer local billers as they believe that local billers are more aware of the billing regulations of the state. But wherever they are located make sure that you don't have to compromise on quality.

HIPAA Compliance: Compliance to HIPAA regulations should be of top priority in order to ensure safety of PHI (Patient Health Information). Most medical billers claim to have adequate knowledge without really knowing the consequence of violation of HIPAA. So before hiring a medical biller , a clinic must verify the seriousness of the candidate towards information handling and avoid any leakage of crucial information.

Willing to learn your process: Your medical billing specialist should be open to learn your style of operations. A medical billing specialist should be able to explain the various steps involved in medical billing as well as explain what steps they can take to meet your specific requirements. Hesitant Billers who avoid making concrete promises may create trouble for you in the long run, it is best to avoid them.

Payer exposure: Denial rates and reasons vary amongst different payers. Careful scrutiny of the contract is necessary to understand the implications of various terms, rates as well as conditions given in the agreement thus saving you from some untoward surprises which you may have to face later on. Your Biller must be aware of the fee schedules and payer contracts for your specific specialty, they could help you improve your collections tremendously.

Nature of Reporting: Being aware of the reporting pattern of your biller, may be a good idea. In general, reports are usually generated on a monthly basis but you can request them to develop special reports for your special needs. Financial Reports are the main tool to judge a billers performance, these reports can help you to enhance your productivity as well as fix problems.

These criteria are an important way to determine the authenticity of the concerned medical billing specialist which every physician or practice must ask before hiring . Now hiring genuine billers will not be a problem for anymore.

The largest consortium of Medical Billers and Coders - medicalbillersandcoders.com can help you to select the biller of your choice.Stretched from Anchorage in Alaska to Honolulu in Hawaii and from Port Orford, Oregon in the west to Boston, Massachusetts in the east, this consortium is the ultimate representation of hundreds of skilled billers with experience in different specialties and updated about the latest technology.Thus making it the one stop solution for all your medical billing specialist requirements as they have in-house billers, home-based billers and Medical Billing company all under the same group. You can choose as per your need.

Nowadays, with the increase in demand for medical billing services many people are entering the medical billing and coding business to offer their services and seek a rewarding career in healthcare. But not every biller is right for your practice, the job of finding the right medical biller for practices can be a difficult task and the cost involved can be quiet high.

You can evaluate your options with the consortium Medicalbillersandcoders.com with its reach in all the fifty states of the United States . This association has categorized Medical Billers by number of years of experience, specialty, software and location. These expert billers have specially come together to help you:

Save Time: The first thing a biller can help you out is to save time. These billers have come together to shorten the time you spend in selecting them. One of the key benefits of hiring our billers from Medicalbillersandcoders.com is quick turnaround time. As a matter of fact it has become the habit of these billers to surpass their turnaround time by streamlining their methods and increasing their efficiency.

Increase Your Reimbursement: The medical billers and coders from Medicalbillersandcoders.com have a proven track record of increasing clients reimbursements. They are updated about the usage of ICD-9 as well as CPT codes and assure correct data entry by assisting in the collection of proper patient demographics. Their orientation to detail is outstanding owing to their billing experience of many years; they even recognize problems and resolve them independently.

Claims Set-up: Medical billing specialists of Medicalbillersandcoders.com administer strict quality measures. Manual check as well as random quality audit with the usage of statistical data is carried out to ensure hundred percent clean claims submission during the first time. They submit claims to clearing houses in order to ensure 100 % accuracy. They even cater to paper based claims and gradually help practices set up electronic submissions, reducing submission time to the same day.

HIPAA Compliance: Understanding HIPAA rules and regulations and how it applies to the providers' office, patients, government agencies, insurance carriers as well as billing policies is of top priority for our medical billers. They are legally responsible and assist physicians to surpass guidelines and secure their data.

Providers' Control over Billing: Providers may ask if they have control over their billing. Their worries are being put to rest since they always have total control over their billing. Checks as well EOBs are sent directly to the providers' offices and at the same time having a 24/7 access to the status of their claims. Specifically printed reports are provided to physicians weekly and monthly to keep them updated financially.

All these factors make our medical billing specialists the preferred choice in the industry. This consortium is a welcome step for the physicians since they can locate medical billers and coders within their city or state with experience in varying specialties and knowledge of software. And the process of matching the right resource to the right physician office, costs nothing. Yes, you heard it right. This consortium can help you to find the best medical billers and coders in the entire United States for free.

You can simply visit the website, find the appropriate Medical Biller in your area and specialty, then dial the toll free number of the consortium or fill out a form asking for certain requirements. And get connected to the biller of your choice, either in your office, home-based or from a professional medical billing service.

WILMINGTON, Delaware, June 1, 2011 - Denial rates of California’s biggest payers being as high as PacifiCare -- 39.6 percent, Cigna -- 32.7 percent, HealthNet -- 30 percent, Kaiser Permanente -- 28.3 percent, Blue Cross -- 27.9 percent, Aetna -- 6.4 percent, the Denial rates in California are witnessed to be on an all time high, as reported by California Department of Managed Care. From 2002 through June 30, 2009, the six insurers rejected 45.7 million claims -- 22 percent of all claims.

Contradicting general expectation, the rate of denial by private players is lesser than the Government program, the Medicare program since its inception acknowledged the existence of regional variations in medical practice reimbursements and has sought to accommodate these differences in adjudicating claims but California denial rates seem to be standing out.But according to the AMA‘s National Health Insurer Report Card annual, Medicare denied medical claims at nearly double the average for private insurers: Medicare denied 6.85% of claims.

The highest private insurance denier across US was Aetna @ 6.8%, followed by Anthem Blue Cross @ 3.44, with an average denial rate of medical claims by private insurers of 3.88%Even after these denial ratios dropped one year, the observed trend suggested that the denial rates are manipulated to suit the requirement of that fiscal year.

Our Medical Billing and Coding specialists suggest the use of industry best practices to accomplish steady income and reduction in denial rates.Medical Billers and coders from our consortium having a base in California have had a close look at the trends in denial management in the past decade, they have managed to discover a pattern or particular reasons for every payer in the state denying claims.

These billers discovered that Carriers differed in how they treated incomplete claims, if information required by the payer to process the claim was missing, the carrier could: Return the claim to the provider, this action of the carrier is like the claim had never been submitted Develop the claim (delay adjudication and try to obtain the required information by contacting the provider) Deny the claim, the provider then had to resubmit the claim or go through the appeal process to obtain payment for this service Denial Management is getting tougher even for specialists as the Carriers even differed in how they interpreted certain national coverage; most specialists are confused as the charge raised by them for different carriers is being treated differently.

A decade long study has also been brought out by expert billers and coders from Medicalbillersandcoders.com, this study reveals resolutions and check list formats of how to bill for the top five deniers in the state of California in order to have maximum payout for physicians and minimum denials.Some of the specialist practices even noticed a denial of 7% of claims submitted in the current fiscal year, with the reimbursements freezing physicians groups are definitely looking to manage profitability better. They are seriously looking for specialists who can handle their denials specifically. Medicalbillersandcoders.com members in California are highly specialized in working denials and depending upon the age of the claims and reasons of denial can even provide assurance of collections.

About Medicalbillersandcoders.comhttp://www.medicalbillersandcoders.com/about-us.aspx Medicalbillersandcoders.com is the largest Consortium of Medical Billers and Coders, come together to service providers with their specialized needs across End to End Revenue Cycle Management, Medical Coding and Denial and Resubmission Management. With a presence across all 50 states and having expert resource servicing all specialties, this consortium is all set to revolutionize the process of locating Medical Billers and Coders.

One may ask why practices require medical billing specialists. A crucial reason might be that taking up the services of a medical biller or a coder may lower overhead costs and expenses but definitely will help the physician to collect more revenues. Physicians across all states are constantly facing difficulties in insurance coding and payment reimbursement in terms of their insurance claims. For them optimizing reimbursement is accompanied with a lot of complexity since there is flux in the medical billing rules and regulations frequently.

Engaging the services of professional medical billers will help the providers to effectively steer their clinics operations towards other functions which can help them grow their practices. Hiring professional services will give the providers an opportunity to manage and organize their business in areas that require critical attention including better patient care, healthcare documentation needs, marketing their own practice and increasing the number of new patients they can retain. Now, before hiring medical billers, a particular practice should take into considerations a few aspects such as:

Experience of Billing Specialists- A thorough and deep understanding of medical billing in terms of multiple specialties is a necessityfor any biller to have a holistic view of the insurance industry. Their experience in handling various processes such as insurance eligibility and benefit verification, charge capture, payment posting, claims transmissions, denial management and follow up on account receivables gives you the confidence to rely on them. [Prerna Gupta] The number of years of experience definitely counts when complex billing situations arise.

Medical Billing Software experience- Before hiring a medical billing service, providers should consider that they are appropriately trained in the usage of medical billing software used in your clinic such as Medisoft, Altapoint, NueMD or any other software. An important characteristic to look for in a medical billing software is that it should easily and effectively process both insurance as well as patient billing and should have the capacity to handle different types of claims. These may include secondary or third party claims and workman’s compensation.

Flexibility- The term 'flexibility' can apply not only to the software but to the billing specialist as they must be willing to learn more. This will be demonstrated by his/her ability to process different types of insurance claims and at the same time handling a number of medical billing situations while dealing with insurance companies and patient queries.

Certification- Certification does not mean everything for a Medical Biller but most Billers who undergo certification process are confident about their knowledge. They also develop the best industry practices and apply them for your clinic. The most popular certification organization, AAPC - American Academy of Professional Coders holds CPC exams across the United States to determine the authenticity of billing and coding professionals. The American Health Information Management Association (AHIMA) also provides most of the certifications and advocates the correct application of CPT, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes. Having certified personnel on board guarantees error free billing for you.

Their Network- It is important for Medical Billers and coders to network with as many professionals as possible specializing in different specialties and billing software. If a particular biller is not confident about the reason for denial or other nuances of the specialty, they could refer their doubts to their peers and seek solutions faster. These Billers are also willing to grow and advance as professionals.

References- Reference can help medical billers to go a long way towards building a healthy client base. This can help providers to trust a medical billing specialist to handle their billing requirements for them. Along with the list of the credentials, a crisp resume, references from former employers or seniors can help the provider to make sure that the medical biller is experienced and trustworthy.

These aspects can be taken into consideration only if you find appropriate candidates to interview, the question arising here is where to locate them? It is best to take the help of medical billing consortium which show the billers willingness to learn, network and grow. Medicalbillersandcoders.com is one such consortium with its reach in all the fifty states of the United States and at the same time provides trained medical billers and coders to physician groups without a fee.

Going to Medicalbillersandcoders.com is a welcome step because it can help physicians to locate Medical Billers and Coders in their city, state, specialty and having experience in their software. Medicalbillersandcoders.com is one of the easiest ways to find the best medical billing specialist, just log on to the website and match your requirement with the available profiles. It is a consortium having hundreds of billers and coders for your preference. They are a specialized lot having experience almost all the specialties including cardiology, dental, dermatology and general surgery.

WILMINGTON, Delaware, May 19, 2011 /PRNewswire/ -- Physicians and Practice Managers across all specialties confidently outsource to experienced billers who choose to work from home but provide doctors efficient services in generating electronic claims, reviewing codes and modifiers, posting payments, and following up with account receivables for insurance payers and patients. Even though most of the small and medium offices prefer to outsource their Medical Billing and coding processes to home-based billers, but the fact that these billers are often unavailable makes it difficult for the Practice Managers to locate them. These home-based billers have low visibility and do not invest in reaching out to potential physician clients unlike billing companies who are all over the internet. Home-based Billers generally close business by word of mouth or references through physicians, this may not be the easiest or fastest way to be visible to new clients. MedicalBillersandcoders.com provides a platform for the home-based billers that not only helps the billers gain high visibility but also makes the task of locating medical billers easier for the physicians. This is basically in keeping with the objective of medicalbillersandcoders.com wherein the consortium aims to service physicians locally and also provide the best medical billers and coders who are experienced in specific specialties and software. Browse All: Cardiology Medical Billing Home-based billers are preferred due to the flexibility and high level of customer service they provide; they always put the need of the Practices before their own and make genuine efforts to help the Practices manage their revenue cycle in a cost effective manner. The other advantage of using home-based billers lies in the fact that the physicians do not have to procure and maintain billing software and face the hassle of electronic medical billing. All these formalities are looked after by a specialist biller who has a ready infrastructure to support their billing process. Physicians save a significant amount of time and expense on administrative jobs and at the same time are able to comply with any government policy related to Healthcare - IT integration. These home-based billers keep themselves updated about government regulations and often guide Practices well in advance about the changes, if any, on compliance issues and reimbursement policies. Home-based billers also realize that as they are often not available to physicians they are never contacted for additional clients. They understand the need for a platform to increase their visibility so as to provide the physicians with abundant choice and hence medicalbillersandcoders.com has seen a surge in the number of home-based billers joining the consortium. Physicians have been impressed with the reach of our consortium and specialized services, which include physician credentialing, denial management, writing appeals, and process flow set-up for various practices. Medicalbillersandcoders.com is being seen as the revolution in locating billers and coders nationally and the quality of billers available on the portal is considered by far the best. Browse All: 'Texas Medical Billing'. About Medicalbillersandcoders.com Medicalbillersandcoders.com is the largest 'Consortium of Medical Billers and Coders,' across the US. The portal brings together hundreds of billers, with experience in different specialties, on the same platform to service physicians in their local areas. This network of coders and billers is growing rapidly and is currently servicing over 50 specialty physicians, across the US, with the most prominent being Cardiology, Mental Health, Dental, and General Practice. Contact: Prerna Gupta, Media Relations 108 West, 13th street, Wilmington, DE 19801 Tel: +1-888-357-3226 Email: info@medicalbillersandcoders.com Website: http://www.medicalbillersandcoders.com/

HostGator offers a number of web hosting services. Before we tell you about one of the distinctive features of HostGator, HostGator coupon, we should have a look onto those services offered by HostGator. Current offer:

Author

Medical Billers and Coders is the largest consortium of Medical Billers and Coders in the United States. Our aim is to help the physician community to reach the right expertise in the right location at the right time.